Provider Demographics
NPI:1720274780
Name:CENTRAL VIRGINIA MOBILE ULTRASOUND, INC
Entity type:Organization
Organization Name:CENTRAL VIRGINIA MOBILE ULTRASOUND, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-832-3198
Mailing Address - Street 1:215 FOX LN
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:VA
Mailing Address - Zip Code:23093-6148
Mailing Address - Country:US
Mailing Address - Phone:540-832-3198
Mailing Address - Fax:540-832-3198
Practice Address - Street 1:215 FOX LN
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:VA
Practice Address - Zip Code:23093-6148
Practice Address - Country:US
Practice Address - Phone:540-832-3198
Practice Address - Fax:540-832-3198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-23
Last Update Date:2007-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARDMS 70964261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile